Lead exposures in U.S. Children, 2008: implications for prevention.
OBJECTIVE
We reviewed the sources of lead in the environments of U.S. children, contributions to children's blood lead levels, source elimination and control efforts, and existing federal authorities. Our context is the U.S. public health goal to eliminate pediatric elevated blood lead levels (EBLs) by 2010.


METHODS
National, state, and local exposure assessments over the past half century have identified risk factors for EBLs among U.S. children, including age, race, income, age and location of housing, parental occupation, and season.


METHODS
Recent national policies have greatly reduced lead exposure among U.S. children, but even very low exposure levels compromise children's later intellectual development and lifetime achievement. No threshold for these effects has been demonstrated. Although lead paint and dust may still account for up to 70% of EBLs in U.S. children, the U.S. Centers for Disease Control and Prevention estimates that >or=30% of current EBLs do not have an immediate lead paint source, and numerous studies indicate that lead exposures result from multiple sources. EBLs and even deaths have been associated with inadequately controlled sources including ethnic remedies and goods, consumer products, and food-related items such as ceramics. Lead in public drinking water and in older urban centers remain exposure sources in many areas.


CONCLUSIONS
Achieving the 2010 goal requires maintaining current efforts, especially programs addressing lead paint, while developing interventions that prevent exposure before children are poisoned. It also requires active collaboration across all levels of government to identify and control all potential sources of lead exposure, as well as primary prevention.
Levin
Ronnie
R
U.S. Environmental Protection Agency, Boston, Massachusetts 02114, USA. levin.ronnie@epa.gov
Brown
Mary Jean
MJ
Kashtock
Michael E
ME
Jacobs
David E
DE
Whelan
Elizabeth A
EA
Rodman
Joanne
J
Schock
Michael R
MR
Padilla
Alma
A
Sinks
Thomas
T
D002648:Child; D004781:Environmental Exposure; D006801:Humans; D007854:Lead / Q000097:blood / Q000633:toxicity*; D007855:Lead Poisoning / Q000209:etiology / Q000517:prevention & control*; D012307:Risk Factors
D007854:Lead